Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Cancer Care

Fremont and San Leandro Medical Centers


When diagnosed early, bladder cancer that hasn’t spread can often be successfully treated. 

It’s important to know the symptoms and risks of bladder cancer. This can help us find it early, when treatment is most likely to be effective.

After diagnostic tests determine the extent of the cancer, we’ll:

  • Talk about your treatment options.
  • Develop a plan that’s right for you. 

We know a cancer diagnosis is overwhelming. However, early-stage bladder cancer can often be successfully treated with surgery, chemotherapy, or radiation therapy.


Transurethral resection of bladder tumor (TURBT)

This is a common surgery used to:

  • Diagnose the cancer and find out how deep it goes into the lining of the bladder.
  • Treat early-stage tumors.

During the surgery, we will:

  • Insert a thin tube with a light and camera into the bladder through the urethra.
  • Use a tool with a wire loop on the end to remove the tumor and possibly deliver an electrical current to burn away cancer cells.

You can usually go home the same day. You might need a catheter to help you urinate for a few days.


This surgery is for more advanced cancer. We remove all or part of the bladder, depending on the size of the cancer. This surgery might be:

  • Partial. We remove small tumors, the part of the bladder with the tumor, and possibly  surrounding lymph nodes.  It’s only used in a small number of cases.
  • Radical. For larger cancers, we remove the entire bladder, nearby lymph nodes, and affected organs. 

You may need several weeks to recover from this surgery.

Bladder Reconstruction

When the bladder is removed, urine needs a new way to exit the body. We’ll make a new path for your body to store and remove urine using one of these methods:

  • Create a new bladder from a section of the small intestine (called neobladder). It’s then connected to the urethra, allowing you to urinate normally.
  • Redirect the urine so it drains through the end of a piece of small intestine (called ileal conduit). Urine then flows into a bag worn on the outside of the body.
  • Develop an internal pouch using tissue from the intestines (called Indiana pouch). You drain the pouch using a catheter.

Surgery Side Effects

Side effects depend on the extent of your surgery. 

With TURBT surgery, the side effects are generally mild. You may have some bleeding or discomfort when urinating for a few days after the procedure. 

When we remove the entire bladder and nearby organs, you may have more serious problems, such as infections and excessive bleeding.

Radical bladder surgery can sometimes damage the nerves responsible for sexual function. It may be possible to reduce the risk of nerve damage with nerve-sparing surgery. 

Possible complications of restoring your ability to urinate are:

  • Urinary tract infections
  • Incontinence (urine leakage)


Chemotherapy drugs may be given to destroy cancer cells before or after bladder surgery. Treatment depends on the extent of your cancer.

For tumors that haven’t spread to the bladder muscle, we may place a liquid drug directly into the bladder through a catheter (called intravesical chemotherapy or immunotherapy). 

Although chemotherapy drugs are sometimes given, an immunotherapy drug called BCG (Bacillus Calmette-Guerin) is most commonly used. BCG triggers the body’s immune system to attack cancer cells. 

If the cancer has spread to the bladder muscle or other tissues, we may use drugs that  circulate throughout your entire body (systemic chemotherapy). These drugs are given through a vein.

When the cancer spreads to other tissues or grows after chemotherapy, we may recommend a different drug (an immune therapy). It can improve your immune system’s ability to attack cancer cells throughout your body (called systemic immunotherapy).  

For those who have changes in the cancer (certain mutations), we may recommend other therapies that target specific problems in the cancer.

Chemotherapy Side Effects

Chemotherapy drugs kill cancer cells, but they can also damage healthy cells. 

Intravesical immunotherapy

This type is placed directly into the bladder. Side effects are generally milder and typically disappear within a couple of days after each treatment. They include:

  • Fever
  • Body aches
  • Difficulty urinating
  • Blood in the urine
Intravesical chemotherapy

Putting chemotherapy into the bladder may cause:

  • An urgent and frequent need to urinate.
  • Pain when urinating.
Systemic chemotherapy

Possible side effects are:

  • Fatigue
  • Nausea and vomiting
  • Diarrhea
  • Hair loss
  • Kidney damage

Additional side effects may include:

  • Decrease in blood counts
  • Susceptibility to infection
  • Infertility
  • Nerve damage
Systemic immunotherapy

This type of chemotherapy can cause:

  • Fever
  • Rash
  • Abnormal blood tests
  • Thyroid dysfunction
  • Diarrhea

Side effects typically go away after treatment. Let us know right away if you develop symptoms. We can help you manage them.

Radiation Therapy

Radiation therapy uses high-energy radiation (X-ray beams) to kill any cancer cells that remain in the bladder area. 

After TURBT, you might have radiation therapy to the bladder and pelvis. It’s sometimes used along with chemotherapy, to treat small tumors, or when can’t have surgery.

Side effects depend on the dose of radiation you receive and the area treated. They may include difficulty with urination and blood in the urine. Most symptoms go away after treatment ends.

Side effects of radiation therapy can often be managed, so let us know if you experience any symptoms.

Clinical Trials

We’re always looking for new and better ways to treat bladder cancer. Clinical trials are research studies that test new treatments or procedures. 

We can talk together about any clinical trials that may be right for you.

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